6. Syphilis and Chancroid Flashcards
T. pallidum MOA
Adheres to vascular endothelium - binds fibronectin
Primary syphillis
Painless infectious chanre (not confined to genitals), painlesss bilateral lymphadenopathy. ~3wk incubation. Resolves 2-8 wks.
Secondary syphillis
6wks to months after 1o sx. rash involving palms and soles. condyloma lata from coalsced papular lesions. generalized lymphadenopathy. Resolves in 2-10 wks.
Tertiary
1-50 yrs after 1o inf. = reactivation of latent syphilis. Late neurosyphilis, cardiovascular syphilis (obliterative endarterisits, anueurysm, asc aorta), late benign syphilis (gummas - granuloma nodules of skin, cartilage and bone)
Neurologic syphilis
Occurs at any stage. Symptomatic early NS - within 1st yr after infection. presents as meningitis. Late NS - ~10 yrs after 1o inf., meningovascular, parencymatous
Late neurosyphilis
- Meningiovascular: endarteritis, trokes
2. Parenchymatous: nerve destruction - tabes dorsalis, general paresis, Argyll Robertson pupil
Syphilis in pregnancy
Miscarriage, preterm delivery.
Congenital syphillis
Rhinitis, saddle nose, skin eruptions, hepatosplenomegaly, pseudoparalysis, lymphadenopathy, and anemia. 3o syphilis complications.
Syphilis diagnosis
- Non treponemal: VDRL, RPR. Titers. False positives/negative (prozone)
- Treponemal - detect Abs, + for life.
Syphilis treatment and prevention
ALWAYS penicillin but Penicillin allergic patients with 1o, 2o, 3o, latent, or cardiovascular syphilis, long courses of erythromycin, doxycycline, or tetracycline may be employed. Infection does not confer protection.
Haemophilus ducreyi xteristics
Gram - facultative anaerobe coccobacillus. Sexual contact. Incub 3-10 days.
Haemophilus ducreyi symptoms
Painful ragged chancres, suppurative inguinal adenopathy
Haemophilus ducreyi diagnosis
History and PE largely
Haemophilus ducreyi treatment
Azithromycin, ceftriaxone, erythromycin or ciprofloxacin
